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HomeMy WebLinkAbout2017-00112 - addn/remodel/repair , . CITY O ORONO * 2 0 1 7 - 0 0 1 1 2 * 2750 KELL Y PARKWAY DATE ISSUED: 02/13/2017 ORONO MN 55356- (952)249-4600 F : (952)249-4616 ADDRESS : 2500 SHADYWOOD RD PIN : 20-117-23-11-0034 LEGAL DESC : REG.LAND SURVEY NO. 163'0 : LOT 000 BLOCK 000 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : COMMERCIAL-BUSINESS CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 437-NONRESIDENTIAL&NaNHOUSEKEEPIN VALUATION : $ 20,000.00 NOTE: SEPARATE PERMITS REQUIRED: PLUMBING,MECHANI�AL,ELECTRICAL(STATE) INERIOR REMODEL FOR SUITES#410 AND#420 I APPLICANT pERMIT FEE SCHEDULE 356.22 Ugorets 8098 LLC STATE SURCHARGE(VALUATION) 10.00 410 11TH AVE S TOTAL 366.22 HOPKINS,MN 55343- Payment(s) (952)769-7249 CHECK 1601 366.22 OWNER Ugorets 8098 LLC 410 11TH AVE S HOPKINS,MN 55343- AGREEMENT AND SWORN STATEMENT The work for which this pertnit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and the State Building Code. This permit is for only the work described and dces not grant permission for additional or related work which requires separate permits. All provisions of laws and ordinances goveming this rype of work shall be compied with whether or not specified hereia This permit will expire and become null and void if construction suthorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time after work has commenced. The applicant is responsible for assuring alI required inspections are requested in conformance with the State Building Code.This permit may be revoked at any time for due cause. �� (� � ��-�-- a/►3/� �°-��� �-� �3 � �� Applicant Permitee Signature Date Issued B ignature Date Z R , , �� ���!.� CITY �F ORONO � ��Qb FEB � 7��(7 BUILDING PE MIT APPLICATION CI'nr oF oRONo FOR NEW STRUC URES OR ADDITIONS �Q A T Mailing Address: Permit number. c�L�I7- �O/l `VO PO BOx 66 Crystal Bay, MN 5323-0066 Date received: ��7'�� � ,, StreetAddress:' Received by: y� G.� 2750 Kelley Parkv�ay 1 0'�� Plan review fee: ��• 5 �9k�SH���C Orono, MN 55356 �1� o�j7-p p!�/ Main: 952-249-4600 , Total Fee: Fax: 952-249-4616 ' www.ci.orono.mn.us This application forrn`musf be completed in ull and ail required information must be submitted. Incomplete applications will be returned. (Please print) 5�;},Qs y�a�-y�lC GENERAL INFORMATION: , Job Site Address: y -}� - a SGG S ho..d, wcc_,� "�,. Will this be a Parade of Homes, Remodelers Showc�se Home or other Display Home? es No If yes,a special event permit is required with Police Department and Cit Council approval 60 days prior to the event. Shuttle bus service will be required un/ess applicant demonstrates su�cient on-site parking is avail b/e. Non-permitted events will not be a/lowed. CONTRACTOR/APPLICANT INFORMATION: Name: State License# Expiration Date: ' Phone: cell (r,�� - - 3 � office Mailing Address: y�0 "' A��, � Cit : k,nz ZIP: ,j'3' Contact Person: R c - Applicant is: Contract / Homeowner (Circle One) Email and/or Fax: � - � PROPERTY OWNER INFORMATION: Name: l��cr�s 8c�I$ �. L.C . Phone(day): (�a_ 3�3 -3 3d 1 , Address: y �� 11''" .,. Cit : o , ZIP: sS y3 Email and/or Fax �.,\� �p �„„dk,���as ,,� ARCHITECT I ENGINEER INFORMATION: Name: �.� -,,} s � Phone(day): ci�,� _ �y� _ g��,D Address: 1�1; }►. pp Cit : ZIP: Email and/or Fax: ;� f �,,� PROJECT INFORMATION: Description of pro'ect: 1.Type of Project 2. Proposed Use 3.Structure Type 4.Sewage Disposal 8 ❑New Construction Water Supply ❑ Single Family th ❑Accessory Bldg./Garage ❑Addition attached gara e ❑ Deck ❑Accessory Building ❑ Sin le Famil ith �Public Sewer g y �Office/Commercial ❑ Relocation detached gara e ❑ Residence ❑ Private Sewer �,Other:(specify) R�mn�� ❑ Multiple Family Condo ❑ Retaining Wall(s) ❑ Public 4-feet or greater ,g(Public Water *`Any earth movement may atso require �Commercial ❑Storage MCWD review 8 permits. ❑ Industrial ❑Warehouse ❑ Private Well Minnehaha Creek Watershed District(MCWD) ❑Other:(SpeCify) ❑Other(SpeCify) 15320 Minnetonka Blvd Minnetonka,MN 55345 Phone: 952-471-0590 Fax: 952-471-0682 www.mi nnehahacreek.or Estimated Construction Valuation (excluding land) $ �C,j _ Qtg� , (�� Last Updated: January 2016 � � STRUCTURE INFORMATION: 1.Structure Dimensions 1. Structure Dimensions(continued) a. Length(ft.)= Number of bedrooms= 2. Occupancy: b.Width(ft.)= Number of garage stalis: 3. Occupant Load: Areas in square feet Attached = Ch��^\ s-h,�-L� c. Basement= Detached = 4. Type of Construction: <.�h��s� �= d. 1 S�Story = e.2"d Story= 1 S� ,*}- 5. Code Edition: f. '/z Story = g.Total Area= REQUIRED SUBMITTALS: All of the information must be submitted in order for your application to be processed: Not Enclosed Applicable ❑ Building Permit Escrow Agreement and Fees ❑ Plan Review Fee � ❑ Completed Application Form ❑ Pro osed Buildin Plans—2 full size sets,to scale and 1 reduced 11 x 17 or 8'/�x 11 set � � Minnesota State Ener Code Calculations and Mechanical Code Re uirements � ksl Survey—2 full size,to scale(meetin ALL survey requirements � Hardcover Calculations � �Sl Septic S stem Certification � � Minnehaha Creek Watershed District(MCWD)Permit or Documentation from MCWD statin no ermit is re uired � ,$1 Landscape Walls and/or Retainin Wall Plans � � Stormwater Pollution Prevention Plan SWPPP � � Access Permit � ❑ Data Privacy Advisory Form APPLICANT/OWNER ACKNOWLEDGEMENT: • Agrees to provide all information required or requested by the Building Department; • Agrees to pay the City of Orono for engineering consultant review costs in excess of$500; • Certifies that the information supplied is true and correct to the best of his/her knowledge. The applicant recognizes that they are solely responsible for submitting a complete application being aware that upon failure to do so, the staff has no alternative but to reject it until it is complete; • Acknowledges the Escrow Agreement is completed and signed; • Understands some or all of the information that you are asked to provide on this application is classified by State law as either private or confidential. Private data is information which generally cannot be given to the public but can be given to the subject of the data. Confidential data is information which generally cannot be given to either the public or the subject of the data. Our purpose and intended use of this information is to annually update our records and records of other governmental agencies required by law. If you refuse to supply the information, the application may not be issued. • Agrees that in the event that weather or other conditions prevent the completion of an as-built survey at the time the Certificate of Occupancy is requested, a temporary Certificate of Occupancy may be issued upon receipt of a $10,000 escrow to ensure co letion of the as-b 'It survey and all site improvements. ApplicanYs Signature: Date: � i Owner's Signature: t� Date: f Last Updated: Janua 01 , . Permit Application: Self-Checklist for Completeness Please note, the applicant must initial in the boxes below to acknowledge the minimum required information is included with the submittal. If not, the application will NOT be accepted Call 952.249.4620 to schedule a meeting with staff if you have questions on application submittal requirements. Completed Application Plan Review Fee Paid �� Signed Escrow Agreement & Escrow Payment �1 Building Plans (to scale) x2 __ Certificate of Survey (to scale) showing the proposed project & meeting all requirements x2 _- - Hardcover Calculations (if applicable) I am aware that Orono will not issue a building permit without a copy of MCWD permits (or documentation from the MCWD stating the proposed project does not trigger their permitting requirements). I will contact the MCWD at 952-471-0590 reg ' g this proj ct � ,- Signed by: L�� Address: o�`�� ��Q �pe �� � �p a � Permit #: _ �p /�-Od / / Last Updated: January 2016 , PLAN REVIEW CHECKLIST FOR NEW STRU��RES / ADDITIONS Address: �`�(�� .Sl�,o'YW�� Sv��l"eS�r j�� �Permit No.: �r�/�` (�0(� 2- Description of work: Date Rec'd: Se tic review b `��!(.(/�Cl�' `� � � Se`�` � �t������'` �`�`� l.� ��, p y: � a �°l� Date Approved: Zoning review by: Date Approved: Building review by: Date Approved: �� � Grading review by: Date Approved: Zoning District: Zoning File#: Reso#: Reso Date: Zoning: Lot Area: SF/AC Width: Lot Coverage: SF % Survey Submitted: � Yes � No Date of Survey: Revised date(?): Landscape plan submitted? 0 Yes ❑ No Landscaper: Proposed Setbacks: Front(Lake) Rear(Street) ( N S E W ) ( N S E W ) Other Buildings Wetland Side Side Defined Height: Peak Height: FFE: FFE minus 6 feet= (Existing Contour) Perimeter(linear feet) = 50°/a = L.F. below grade Basement? 0 Yes 0 No, Stories FOR A BUILDING WITH A BASEMENT OR CRAWL SPACE: FOR A BUILDING ON A SLAB FOUNDATION: The distance between the lowest proposed Slab at or above grade— START WITH floor(of the basement or crawl space)and measure from hiahest existina the highest point of the roof. START WITH rp ade to the highest point of the roof even if fill was brought in to elevate home. If you have a... SUBTRACTION • GABLE OR HIPPED ROOF(no Slab below grade—measure (BASED ON windows): Subtract half the distance from highest existing grade to the ROOF TYPE) between the highest point of the roof hi hest oint of the roof. to the low point of the corresponding If you have a... gable or hipped roof SUBTRACTION ' GABLE OR HIPPED ROOF • GABLE OR HIPPED ROOF(with (BASED ON (no windows): Subtract half windows): Subtract half the distance ROOF TYPE) the distance between the between the top of the highest highest point of the roof to window and the highest point of the the low point of the roof corresponding gable or hipped roof • ALL OTHER ROOF TYPES(flat, . GABLE OR HIPPED ROOF mansard,etc):No subtraction. (with windows): Subtract SUBTRACTION Subtract the distance between the half the distance between (BASED ON basemenUcrawl space floor and the the top of the highest EXISTING highest existing grade adjacent to the window and the highest GRADES) foundation OR 10 feet(whichever is less). point of the roof • ALL OTHER ROOF TYPES (flat,mansard,etc):No EQUALS Defined building height subtraction. Defined building height EQUALS Updated: October 2015 z:\forms\plan review checklist 10-2015.docx I Shoreland District MCWD Permit Average Lakeshore Setback Bluff Met? 0 Yes p No Permit Number: � Yes 0 No � N/A � Ye No � � N/A—see attached Setback: Stormwater Quality Existing Proposed Overlay District Tier Hardcover Hardcover Variance Required CUP Required circle one % and sf % and sf 0 Yes 0 No � Yes 0 No 1 2 3 4 5 Type(s): Type(s): Fees to be Char ed YES NO Perm it Plan Review ". �'` State Surcharge l/' Investigation Fee V' SAC—Number of SAC Units (� Other(specify) �/' Square Footage $ per Square Footage Basement X = $ 1 S' Floor X = $ 2nd FIOOr X = $ Garage X = $ Estimated Construction Value: $ � �%, �(it/ Orono Inspections Required Work Requiring Separate Permits � Footing � Site Plumbing � Grading/Filling 0 Poured Wall 0 Silt Fence/Erosion Control Mechanical � Fire 0 Foundation Survey 0 Hardcover Removal 0 Septic ❑ Water Connection 0 Foundation Waterproofing 0 Other(specify) 0 Fireplace ❑ Sewer Connection Framing 0 Masonry 0 Lawn Irrigation Insulation 0 Mfg. ❑ Landscaping 0 As-Built Survey 0 Other(specify) �Final � Lathe Required State Permits 0 Other(specify) 0 Well Electrical � c REMARKS (in-house): OFFICIAL REMARKS -TO BE NOTED ON PERMIT AND INITIALLED: � See Builder Acknowledgement Form � Prior to release of escrow money an as-built survey and hardcover calculations must be submitted and approved. Updated: October 2015 �•\fnrmc\nlan ravia�ni rharklict 1(1_7(115 rinrr ,.<'te�' � q. � u��n �C i 'r'�,�. 'ti' y �` �� p�r�yll'�.. �,� � ��• ��� � � � ,� ' ' •�►�iy�l, �. •�Y-.x 1 -�r`�,., rril''#'.,�#,�,.. '+rf°+:,'c` � � ' M�"�- ��1� = W I LKU S �.�„ �y.�az'_ :����. .. ;, , . ..., ,p, . _ ,:�- , .„ , . —.,.�._�� t� . .. ., .. .�y� . .., II 4 r. _,....�.,. '. . . K ..n... .....,.�.�. � ...i .`�. ` � }...�y��w ',�.T 6'#< r.r _ .r'�"'"A'i c. � F x .. � # { c � .... . � •- �k.i �f � t . F ,> .. �:. „Jt�..�t�F ;z; � _. . . e *,.���9�a��...:... Sv:7S LL ` �� �' �� i ,e� �. _ _ � ._�.z;'_.. ^ � �.x I� � " � .;4` � .. . ��� � ( L��1 aioirtn.nveHuesourH HOPKINS.MN 553C1 - .. '�.� � PHONE:61]1363-3331 .�—�^ '... .I:. . � -^_�-. � " :�� . 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